Name:	Omni Manor, Inc.
Real Party In Interest:
Type of industry:	Nursing Home
Address:	101 West Liberty Street
Address 2:
City:	Girard
State:	Ohio
Zip Code:	44420
Contact Person:	John J. Masternick
Phone:	330-545-1550
E-Mail:	jjmasternick@windsorhouseinc.com

III. Brief description of the Executive Agency Decision(s) to which this engagement relates:
Nursing Home Issues
IV. Categorical listing of offices of Elected Executive Officials, Departments or Executive Agencies to which the engagement relates:
Governor
Job & Family Services
Medicaid, Department of